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“the state of complete physical, mental, and social well-being and not merely the
absences of disease or infirmity.”
Approaches to health
Critics: Too mechanistic, treat patients like machines. Doctors cannot and should
not try to diagnose or treat unobservable conditions – cannot be identified/tested.
Excludes how patient feels.
Critics: people with chronically disease but socially active is healthy. Doctors
define a set of conditions as healthy and not other set. Those who claim to be sick
but not recognized as sick are subjected to social disapproval and sanction.
Disregard the presence or absence of disease (focus on how the patient act).
Critics: Measure not well developed to measure stress level - not objective. No
single instrument to measure feeling. Nothing like blood test.
Focuses on the whole person, but does not point out who is sick and what kinds of
treatments are needed.
Morbidity and Mortality – the non-health indicators. Measure these to understand health.
Non-health are easier to measure.
Mortality – usually measured with death certificate.
Morbidity – nonhealth side of the coin that raises all the same issues that we encountered
in trying to define health. Count person with disease, but what do you do with those who
do not know they have a disease, or those who deny the disease (e.g., HIV/AIDS)
Years of Potential Life Lost (YPLL) – sum of number of years “lost” when people
die before a given year, and it reflects the expected life span for the whole
population or specific portion of a population. YPLL is calculated as the
difference between the actual age of death and some specific, expected age of
death, for example, seventy-five. The number of years lost by whole categories of
people is summed to capture the impact of premature death on specific
populations.
Infant mortality – “how well a society cares for its most vulnerable member is generally
regarded as the best indicator of a society’s ability to care for all of its members” (25).